Reactive Hypoglycaemia - please help a noob

[JaxFrost]

Hi folks 🙂

I'm new here. I got Reactive Hypoglycaemia after having a gastric bypass (it's one of the only long-lasting complications) and it means I don't get any support from the NHS other than a dietician. Who has been great, but I have to pay for my blood glucose monitoring things. I don't even have a Diabetes Nurse I can ask because I'm not strictly diabetic. So I'm alone in this.

I recently lost my job and can't afford to buy the Freestyle Libre anymore. £100 per month is pretty steep.

Can you pretty please advise the cheapest blood glucose monitoring kit?

I get frequent hypos after eating any carbs whatsoever. It doesn't matter what they are. The dietician wouldn't have believed me if I hadn't printed out the Freestyle Libre graphs to show her! If I eat up to 30g of carbs per meal as they recommend, I'd be in the red within 2 hours. 10g is even too much. So I have to be mindful. If I eat a meat stew and someone thickens it with a little flour, I still get a reaction - so I need to be on it.

And how do I use the finger pricking BGM? Before food? Then how long after food?

I'd be so grateful for your help. I don't have access to anyone and my GP refuses to answer these questions because she says she's not a specialist. Which is fine but it leaves me with... nobody to ask. I live alone and I worry about having a hypo overnight, which does happen.

Thanks a mil 🙂

 

[everydayupsanddowns]

Welcome to the forum @JaxFrost

Sorry to hear about the difficulties you are facing

The most affordable (and reliable/accurate) meters self-funding members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £8 for 50

For reactive hypoglycaemia I guess you would check whenever you feel hypo symptoms

For monitoring around meals to try toreduce BG spikes (and hopefully reduce risk of reactive hypos) test-review-adjust by Alan S is a very useful framework.

Good luck and let us know how you get on 🙂

 

[everydayupsanddowns]

You might also find this a helpful rundown of hypo symptoms to look out for.

What is a hypo (hypoglycaemia)?

A hypo is when your blood sugar level, also called blood glucose level, drops too low. This is usually below 4mmol/l. A hypo, also called hypoglycaemia, can happen quickly. So it’s important to always have hypo treatments with you. It's also important to know what the signs are and how to treat...

www.diabetes.org.uk

Bear in mind, if you’ve only been seeing hypos on Libre traces that some of your small dips may have been overstated - Libre can read a little lower at low levels and a little higher at high levels in some people, which can mean you appear to get more time in the high 3s (clinically an alert level, rather than actual physiological hypoglycaemia) where you may still have been mid-4s depending on how Libre works for you and the direction of travel.

 

[JaxFrost]

You might also find this a helpful rundown of hypo symptoms to look out for.

What is a hypo (hypoglycaemia)?

A hypo is when your blood sugar level, also called blood glucose level, drops too low. This is usually below 4mmol/l. A hypo, also called hypoglycaemia, can happen quickly. So it’s important to always have hypo treatments with you. It's also important to know what the signs are and how to treat...

www.diabetes.org.uk

Bear in mind, if you’ve only been seeing hypos on Libre traces that some of your small dips may have been overstated - Libre can read a little lower at low levels and a little higher at high levels in some people, which can mean you appear to get more time in the high 3s (clinically an alert level, rather than actual physiological hypoglycaemia) where you may still have been mid-4s depending on how Libre works for you and the direction of travel.

Thank you so much! I'll look into that article and look up those devices. x

 

[Inka]

Hi folks 🙂

I'm new here. I got Reactive Hypoglycaemia after having a gastric bypass (it's one of the only long-lasting complications) and it means I don't get any support from the NHS other than a dietician. Who has been great, but I have to pay for my blood glucose monitoring things. I don't even have a Diabetes Nurse I can ask because I'm not strictly diabetic. So I'm alone in this.

I recently lost my job and can't afford to buy the Freestyle Libre anymore. £100 per month is pretty steep.

Can you pretty please advise the cheapest blood glucose monitoring kit?

I get frequent hypos after eating any carbs whatsoever. It doesn't matter what they are. The dietician wouldn't have believed me if I hadn't printed out the Freestyle Libre graphs to show her! If I eat up to 30g of carbs per meal as they recommend, I'd be in the red within 2 hours. 10g is even too much. So I have to be mindful. If I eat a meat stew and someone thickens it with a little flour, I still get a reaction - so I need to be on it.

And how do I use the finger pricking BGM? Before food? Then how long after food?

I'd be so grateful for your help. I don't have access to anyone and my GP refuses to answer these questions because she says she's not a specialist. Which is fine but it leaves me with... nobody to ask. I live alone and I worry about having a hypo overnight, which does happen.

Thanks a mil 🙂

Hi @JaxFrost How frustrating and worrying for you. I understand why your GP doesn’t want to give advice, but are you able to access advice from the clinic/consultant who did your bypass? I know RH isn’t a common result of a gastric bypass but it’s not that rare and you can’t be the only person experiencing this, I’d think.

If even the flour in a beef stew affects you, then perhaps you might need medication? I know there are things you can have to help a bit. I can’t remember whether they slow down the food absorption or reduce the insulin response, but there are options to explore.

As for having a hypo at night, that’s a completely understandable worry. I guess not eating for a few hours before bedtime would make that unlikely.

 

[helli]

I live alone and I worry about having a hypo overnight, which does happen.

Do you experience the hypos at night or do you see them on your Libre graphs?
Libre (and other CGM) can suffer from compression lows. These are where they read artificially low when pressure is applied to them. This happens most often when we are asleep and we lie on the arm with the sensor. This shows up on my graphs as temporary dips for a couple of readings and then back up to "normal" probably when I move because my arm is going dead.

I don't want to suggest your problems are not serious but, as @everydayupsanddowns mentioned, Libre are not always accurate and this is one occasion when its inaccuracies can be most scary.

 

[trophywench]

Err, all the NHS advice on reactive hypo I have just found is based on the assumption that the patient CAN test their BG at the drop of a hat when necessary - so unless their advice to their doctors says the diametric opposite of this how the heck can they refuse?

 

[JaxFrost]

Hi @JaxFrost How frustrating and worrying for you. I understand why your GP doesn’t want to give advice, but are you able to access advice from the clinic/consultant who did your bypass? I know RH isn’t a common result of a gastric bypass but it’s not that rare and you can’t be the only person experiencing this, I’d think.

If even the flour in a beef stew affects you, then perhaps you might need medication? I know there are things you can have to help a bit. I can’t remember whether they slow down the food absorption or reduce the insulin response, but there are options to explore.

As for having a hypo at night, that’s a completely understandable worry. I guess not eating for a few hours before bedtime would make that unlikely.

Hi Inka, thanks a mil for that. I hadn't thought that medication was available! What a good thing to explore. I had the surgery done privately, but I'll email the bariatric dietician right away. You're a star! xxx

 

[JaxFrost]

Do you experience the hypos at night or do you see them on your Libre graphs?
Libre (and other CGM) can suffer from compression lows. These are where they read artificially low when pressure is applied to them. This happens most often when we are asleep and we lie on the arm with the sensor. This shows up on my graphs as temporary dips for a couple of readings and then back up to "normal" probably when I move because my arm is going dead.

I don't want to suggest your problems are not serious but, as @everydayupsanddowns mentioned, Libre are not always accurate and this is one occasion when its inaccuracies can be most scary.

Hi Helli x. I am asleep when I have the hypos so I don't feel much, but I get more hypos in the day thankfully, in reaction to my eating. But it is fascinating what you say about the compression factor. I can completely see that's happened to me before where I've been lying down and thought to myself, "Huh? Surely not. I can't be having a low..." So that is good to know!

 

[JaxFrost]

Err, all the NHS advice on reactive hypo I have just found is based on the assumption that the patient CAN test their BG at the drop of a hat when necessary - so unless their advice to their doctors says the diametric opposite of this how the heck can they refuse?

Hi Jenny x Bless your heart. My surgery seems to be worried about getting sued all the time. They keep saying, "We're GENERALists. We're not specialists..." So I asked if a generalist doctor could write a prescription for a BG device with strips for someone who needs it for good reason, and she said no. Unreal. Perhaps I should ask for that in writing - lol!

 

[everydayupsanddowns]

Hope you can get a meter and strips on prescription @JaxFrost 🙂

 

[JaxFrost]

Hope you can get a meter and strips on prescription @JaxFrost 🙂

So do I m'dear x. Thank you!

 

[NatS]

Hi Jax

Did you get anywhere with the tests strips?

My GP was amazing when I approached her and I can now get test strips on prescription for potential reactive hypoglycaemia. Is your gp supportive?

 

[SueinLincs]

Hi Helli x. I am asleep when I have the hypos so I don't feel much, but I get more hypos in the day thankfully, in reaction to my eating. But it is fascinating what you say about the compression factor. I can completely see that's happened to me before where I've been lying down and thought to myself, "Huh? Surely not. I can't be having a low..." So that is good to know!

Like you I have RH after bypass surgery and can’t get any support. I know if I’ve had a real overnight hypo because I’ll have awful dreams, find it difficult to wake up and will feel completely drained. The last 2 times I’ve felt suicidal. Trying to get help is like banging your head against a brick wall.

 

[SueinLincs]

Hi Jax

Did you get anywhere with the tests strips?

My GP was amazing when I approached her and I can now get test strips on prescription for potential reactive hypoglycaemia. Is your gp supportive?

Actually one of the gp’s is lovely and will prescribe the strips but I really need the Libre because I’ve had hypos when I’ve tested every 45 minutes and that’s just not practical.

 

[grovesy]

Neither poster you have replied to have been on the forum for some time, so you may not get a reply.